What we are doing
Building on the work already done by the National Clinical Programme for Paediatrics and Neonatology, and in collaboration with it, the Integrated Care Programme for Children (ICPC) is being developed to design a mechanism by which an appropriate, effective, timely, continuum of care for children can be achieved, based around the specific needs of the child. The Programme is in its early stages of establishment. The first phase of the programme includes:
- Defining the scope
- Mapping current/planned work-streams in the HSE in relation to children
- Child/family engagement
- Establishing programme priorities, objectives and resources
- Setting up the programme steering and working groups and supporting governance structures
Establish a Framework for Integrated Care for Children:
The purpose of establishing a Framework for Integrated Care for Children is to identify key components, principles and next steps, as services look to integrate care for children. The ICP for Children aims to collaborate on service design and delivery across divisions and disciplines and to provide the platform to stimulate discussion at regional and national levels. Milestones and deliverables for 2017 are largely structural and include:
- Establish programme team and Steering Group
- Identify integrated care workstreams and prepare 2017 plan
- Finalise PID
Implement the National Model of Care:
The model of care for Paediatric and Neonatal Healthcare Services was developed by the National Clinical Programme for Paediatrics and Neonatology. It was approved in June 2016. The design of the implementation strategy is therefore in the early stages i.e. ‘Exploring & Preparing’. Key milestones for 2017 include:
- Agree Governance arrangements
- Establish implementation team
- Prepare stakeholder engagement plan
- Prepare implementation strategy and associated plan
- Draft communications plan
Identify, evaluate, prioritise and progress service improvement initiatives:
There are currently a number of service improvement initiatives being undertaken by the ICP for Children (details below). Some of these initiatives will continue into 2018. There are also a number of additional projects which have been approved by the steering group and programme team for 2018 consideration.
2017 Improvement Initiatives
- Consultant delivered service
A pilot project has been initiated in University Hospital Waterford to develop a consultant delivered service. The anticipated benefits of the project will be an increased presence of senior decision makers, an increase in special interest clinics, reduced length of stay, reduced admissions, EWTD compliance, greater patient/family and staff satisfaction and reduction in costs. The first year of a three year project will entail the recruitment of three additional consultant paediatricians in Waterford in 2017.
- Integrated care pathway for children with neuromuscular disorders
The ICP for Children has started a project to develop a standardised pathway for children and young people aged 0-18 and their families, with neuromuscular disorders in Ireland. It is intended that this pathway will become a road map for people providing services. Development of this integrated care pathway will help identify the right people, in the right order, in the right place, at the right time, achieve the right outcomes, all with the child and family experience at the centre of how we deliver our service.
- Targeted hip ultrasound screening programme for infants at increased risk of Developmental Dysplasia of Hip (DDH)
The ICP for Children has secured funding to implement phase 1 of a selective screening programme for infants at risk of DDH. Having a selective ultrasound screening programme in place will ensure that infants in Ireland at risk of DDH are managed in an equitable manner according to an agreed national standard. As well as equity of access to an agreed national standard of care, it is anticipated that the number of open and closed reduction surgeries will be reduced. A gap analysis has been carried out to determine the resource requirement for the staff, training and equipment required to implement. Phase 1 includes the relevant hospitals in the South/Southwest, University of Limerick and Saolta hospital groups. It is intended that phase 2 of the programme would be implemented in 2018.
- Development of a perinatal hepatitis B prevention programme in Ireland in collaboration with the Health and Wellbeing division.
A multidisciplinary working group is developing a care pathway for pregnant women who are hepatitis B positive and the babies born to these mothers. The roles and responsibilities for the various healthcare professionals involved will be defined as well as the quality standards and performance indicators for monitoring the screening and prevention programme.
- Integrated care pathway for the aetiological investigation and subsequent management of infants with permanent childhood hearing impairment.
The ICP for Children has convened a multidisciplinary group to develop an integrated care pathway for the aetiological investigation and subsequent management of infants with permanent childhood hearing impairment (PCHI). The care pathway will build on the success of the Universal Newborn Hearing Screening (UNHS) programme and will seek to ensure that infants identified with a hearing impairment are investigated and managed according to nationally agreed standards.